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Cardiac Surgery Can Impact Long-term Cognitive Functioning, Suggesting Need for Monitoring and Rehab

Post-Op Delirium’s Toll on Men­tal Func­tion May Linger: Study (US News):

Delir­ium after car­diac surgery has been thought of as a brief, reversible con­di­tion, but new research is sug­gest­ing that [men­tal] recov­ery for some peo­ple may take much longer than thought, and that there are long-term cog­ni­tive con­se­quences,” said study co-lead author Jane Saczyn­ski, assis­tant pro­fes­sor of med­i­cine at the Uni­ver­sity of Mass­a­chu­setts Med­ical School in Worcester…Patients should also have their men­tal func­tion­ing tested before they leave the hos­pi­tal, Grote added…“You can’t rely on casual con­ver­sa­tion to know patients are hav­ing prob­lems,” he said. “Some are able to put up a social facade. They are chatty, witty and fun to be with, but when you start push­ing you find out there’s a problem”…Saczynski said the find­ings also sug­gest that reha­bil­i­ta­tion pro­grams may need to con­tinue for longer than the typ­i­cal three months.”

Study: Cog­ni­tive Tra­jec­to­ries after Post­op­er­a­tive Delir­ium (NEJM). Abstract:

  • METHODS: “We enrolled 225 patients 60 years of age or older who were plan­ning to undergo coronary-artery bypass graft­ing or valve replace­ment. Patients were assessed pre­op­er­a­tively, daily dur­ing hos­pi­tal­iza­tion begin­ning on post­op­er­a­tive day 2, and at 1, 6, and 12 months after surgery. Cog­ni­tive func­tion was assessed with the use of the Mini–Mental State Exam­i­na­tion (MMSE; score range, 0 to 30, with lower scores indi­cat­ing poorer per­for­mance). Delir­ium was diag­nosed with the use of the Con­fu­sion Assess­ment Method. We exam­ined per­for­mance on the MMSE in the first year after surgery, con­trol­ling for demo­graphic char­ac­ter­is­tics, coex­ist­ing con­di­tions, hos­pi­tal, and surgery type.”
  • CONCLUSIONS: “Delir­ium is asso­ci­ated with a sig­nif­i­cant decline in cog­ni­tive abil­ity dur­ing the first year after car­diac surgery, with a tra­jec­tory char­ac­ter­ized by an ini­tial decline and pro­longed impairment.”

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